title: Evaluation of xenogenic extracellular matrices as adjuvant scaffolds for the treatment of stress urinary incontinence.
abstract: OBJECTIVE
  Tissue-engineered biomaterials have shown recent promise as adjuvant scaffolds for treating stress urinary incontinence (SUI). The objective of the present study was to compare their mechanical and regenerative properties with synthetic biomaterials in this urogynaecological setting.
  
  
  METHODS
  The biomechanical properties of polypropylene (Serasis®; n = 12), four-ply urinary bladder matrix (UBM; n = 12) and four-ply small intestinal submucosa (SIS; n = 12) were determined with uni-axial tensile testing protocols and compared with stress-strain curves. Subsequently, human dermal fibroblasts (2.5 × 10(4)cells/cm(2)) were cultured onto each biomaterial under conventional laboratory growth conditions for 12 consecutive days. Attachment, viability, and proliferative activity of fibroblasts were evaluated and compared using quantitative viability indicators and scanning electron microscopy.
  
  
  RESULTS
  There were no significant differences in the biomechanical properties of each biomaterial assessed. Incremental stiffness at 0-10 % strain measured 5.73 ± 0.36 MPa for polypropylene compared with 8.23 ± 0.92 MPa and 6.81 ± 0.83 MPa for SIS and UBM respectively (p > 0.05). Viability and proliferative activity of fibroblasts differed significantly on all three biomaterials with the luminal and abluminal surfaces of the UBM demonstrating significantly greater rates of fibroblast proliferation compared with polypropylene and SIS (p < 0.01).
  
  
  CONCLUSIONS
  This is the first comparative study on porcine UBM, porcine SIS, and synthetic polypropylene as adjuvant scaffolds for the treatment of SUI. Our results demonstrate that porcine UBM may provide an attractive alternative owing to its superior remodelling potential.
authors.affiliation: Department of Urology, University of Limerick Teaching Hospital, Co. Limerick, Ireland, nialldavis2001@yahoo.com.
authors.forename: Niall F
authors.initials: NF
authors.lastname: Davis
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Coakley
authors.forename: Anthony
authors.initials: A
authors.lastname: Callanan
authors.forename: Hugh D
authors.initials: HD
authors.lastname: Flood
authors.forename: Tim M
authors.initials: TM
authors.lastname: McGloughlin
mesh_terms: D000818:Animals; D001672:Biocompatible Materials; D001696:Biomechanical Phenomena; D049109:Cell Proliferation; D002470:Cell Survival; D005109:Extracellular Matrix / Q000502:physiology* / Q000648:ultrastructure; D005347:Fibroblasts / Q000502:physiology; D006801:Humans; D007413:Intestinal Mucosa / Q000502:physiology* / Q000648:ultrastructure; D008422:Materials Testing; D011126:Polypropylenes; D013526:Surgical Mesh; D013552:Swine; D013718:Tensile Strength; D054457:Tissue Scaffolds; D001743:Urinary Bladder / Q000502:physiology* / Q000648:ultrastructure; D014550:Urinary Incontinence, Stress / Q000628:therapy
chemical_list: D001672:Biocompatible Materials; D011126:Polypropylenes